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Pain Versus Pleasure

I recently had the opportunity to view the Netflix short series, Painkiller. The series discusses the opioid epidemic and crisis in a similar fashion to Hulu’s earlier release entitled Dopesick. The Netflix series provides an even broader perspective spending a lot of time on both one of the investigators from the U.S. Attorney’s office, as well as the member of the Sackler family that spearheaded the drug being mass produced and marketed. Additionally, he displays the conflicted feelings of the drug salespeople and the devastating impact it has on a working-class family when their patriarch becomes addicted to oxycontin.

The Debate

Drugs are not new to certain communities. They have long been used to circumvent pain, poverty, and to mask larger health issues, particularly in communities of color and other marginalized communities. Crack and heroin are just two drugs that ripped apart these same communities. Crystal meth tore through rural areas and impacted marginalized communities with little mention or effort to combat it. The creation of oxycontin as a prescribed medication and its widespread use inflicted something entirely different on these communities. Additionally, as a certified safe-for-use prescription drug, it allowed for its usage to become more widespread and not just limited to certain areas.

The series Painkiller did an excellent job of showing how the Sackler family set the tone for the ownership of becoming an addict to lie solely at the feet of those who fell victim to simply trusting their medical professionals. People who simply went to their trusted medical professional for help after a fall or accident and suffered from post-trauma pain were offered prescriptions for this drug that all but seemed to appear out of nowhere. It was pushed with the zealousness of a miracle drug to cure all pain. Essentially, the drug company’s reps functioned as street drug dealers in pushing and promoting their dangerous product to doctors, some of whom fell victim to the greed of money in exchange for overprescribing oxycontin.

There has often been a debate primarily put forth by big pharmaceutical companies that prescription drugs are ethical and approved. They argue that management of any mitigating side effects lies within the scope of the doctor and their patient. The doctor often leaves it up to the patient to self-report any adverse impacts on their lives. The important piece missing from this argument is the truth being told to unsuspecting patients, it is not clear how addictive the drug could be and how hard it is to beat the addiction. Lawsuits are presently being filed against large companies regarding the overprescribing of these drugs. A large drugstore chain is rumored to be filing bankruptcy because of existing or future oxycontin-related lawsuits.

At the height of the introduction and increased usage of this drug, millions were made. The flip side was thousands were becoming addicted and there was no accountability from anyone, including those who prescribed or the drug manufacturer. Imagine being faced with the perception that it is your fault you became addicted. The shame and guilt compounded with a life-changing and at times life-threatening disease and society taking no blame or action to intervene.

This issue brings to light a larger debate on the medical community’s ability to teach its residents and doctors proper pain management. What became obvious to many who took oxy was that the high was the real way to beat the pain and that the drug did not necessarily address their pain. Both series show the quick ability to build up a tolerance which caused higher dosages of the drug to be described. It was at this point that addiction settled in. Oxy was new and most doctors relied heavily upon how the drug was marketed and its promising impact, while some had seen early on the potential harm and thankfully did not prescribe. The question remains, did this drug do what it was created to do, or did it essentially create a drug epidemic crisis amongst not just the marginalized community but anyone who could get their hands on it?

The Response

The response to the overprescribing of this narcotic or as some refer to it as the prescription heroin has been swift. Yet, it is still on the market, and still prescribed. Many may wonder, including myself, how a drug that can be so powerfully addictive still be available. As with some medications, the risk versus reward ratio is examined. This speaks to the fact that virtually every medication prescribed may have some impact on people. Some people may have more severe outcomes than others, yet the overall benefit outweighs any adverse issues. However, there have been more reported data showing the risk versus reward ratio may not be worth it for those who have preexisting addictive traits.

For those who have a predisposition to addiction or inherited traits, this provides little comfort. The real solution as with all drugs is to have a candid discussion with your medical professional and ensure that your concerns are taken into consideration and not ignored. The current day demise of some larger drug store chains and pharmaceutical company fallout are all evidence that this epidemic is far from over and the repercussions are still being felt. The response regarding accountability is finally picking up traction and momentum. Families and loved ones whose lives have been upended by this drug can finally hold those manufacturing it accountable. People of all ages who simply sought medical treatment ended up being handed a sentence of being addicted to a drug that is extremely difficult to detox from. The lesson is that opioid addiction and oxycontin is no longer just a problem for marginalized communities, it is an issue for everyone. Painkiller successfully showed how greed, power, and money can lead to the ultimate betrayal of helping mankind. A drug marketed to help people instead of knowingly was created and sold to promote over-usage at the expense of countless people just to turn a profit.

The next time you are prescribed pain medication or any medication, be sure to discuss the risks versus rewards and to carefully review any potential side effects. Anything that you are not comfortable with is worth mentioning to a trusted medical professional. Ask questions and do not be afraid to bring up worse-case scenarios with doctors as failure to do so could lead you to making the wrong decision.


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